BMC Neurology最新文献

Background: Virtual reality (VR) has emerged as a promising tool in neurorehabilitation to improve motor function in individuals with hemiplegia. VR applications are typically categorized into immersive and non-immersive types, both of which have demonstrated efficacy in enhancing upper limb function. This study aimed to compare the effectiveness of immersive virtual reality (IMVR) and non-immersive virtual reality (NIVR) therapies in improving upper limb motor function in individuals with subacute hemiplegia.

Methods: This single-blinded randomized controlled trial included 30 participants (aged 25-40 years, both male and female) with subacute hemiplegia. Individuals with pre-existing musculoskeletal or neurological conditions affecting the upper limb, severe motion sickness, photosensitivity, or perceptual deficits were excluded. Participants were randomly allocated into two groups: Both groups initially received conventional physiotherapy, following which the immersive VR and non-immersive VR interventions were administered to the respective group. Each session lasted 60 min, with three sessions per week for six weeks. Assessments were conducted at baseline, post-intervention (6 weeks), and follow-up (6 months) using the Fugl-Meyer Assessment (FMA), Wolf Motor Function Test (WMFT), and Stroke-Specific Quality of Life Scale (SS-QOL). The System Usability Scale (SUS) and User Experience Questionnaire (UEQ) were used to evaluate the safety and usability of both VR methods.

Results: No statistically significant differences were observed in baseline characteristics between the groups. SUS and UEQ scores also showed no significant differences in user experience. However, IMVR demonstrated statistically significant improvements in FMA, WMFT, and SS-QOL scores compared to NIVR at both post-test and follow-up (p < 0.05).

Conclusion: Both immersive and non-immersive VR therapies were effective in enhancing upper limb motor function and quality of life among individuals with subacute hemiplegia. However, IMVR showed greater clinical significance in improving motor function and quality of life. Future research should explore the integration of VR across different stroke stages and focus on developing simple, task-specific games to further support rehabilitation.

Trial registration: This clinical trial was registered in clinicaltrials.gov under the trial ID NCT06615141 on September 26, 2024.

Background: Parkinson's disease (PD) is a chronic neurodegenerative disorder characterized by motor and non-motor symptoms, with neuroinflammation hypothesized to contribute to its pathogenesis. Systemic inflammation, as indicated by elevated peripheral inflammatory markers, has been implicated in PD; however, the relationship between complete blood count (CBC)-derived inflammatory markers and the presence of PD remains unclear.

Methods: We analyzed data from the National Health and Nutrition Examination Survey (NHANES) spanning 1999 to 2018, including 15,349 participants. Propensity score matching was employed to balance baseline characteristics between PD and non-PD groups. Multivariate logistic regression models were used to evaluate the association between CBC-derived inflammatory markers, particularly the neutrophil-to-lymphocyte ratio (NLR), and the presence of PD.

Results: After multivariable adjustment, elevated NLR was significantly associated with higher odds of PD. Individuals in the highest NLR quartile had higher odds of PD compared to those in the lowest quartile (OR: 2.18, 95% CI: 1.04-4.68; P for trend < 0.0001). This association was consistent across subgroups, including gender, diabetes status, hypertension, obesity, smoking, and alcohol consumption. Other CBC-derived markers, such as the monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI), did not show consistent associations with the presence of PD.

Conclusions: Elevated NLR is significantly associated with the presence of PD among U.S. adults, independent of key confounders. However, due to the cross-sectional study design and reliance on self-reported PD status, causality cannot be inferred, and misclassification bias cannot be excluded. Further longitudinal studies are warranted to validate these findings and clarify the temporal relationship between systemic inflammation and PD.

Background: Symptom burden in primary brain tumor patients varies, emphasizing the need for comprehensive understanding to improve patient care. This study aims to identify distinct symptom clusters among brain tumor patients in Shanghai, China, using Latent Profile Analysis (LPA) to guide personalized diagnosis, treatment, and supportive care.

Methods: A longitudinal study was conducted among 161 patients with primary brain tumors in Shanghai. Participants completed the MD Anderson Symptom Inventory Brain Tumor Module (MDASI-BT) at three intervals: the day of admission (T1), three days after surgery (T2), and two weeks after surgery (T3). Latent Profile Analysis (LPA) was used to identify subgroups with unique symptom patterns.

Results: Six distinct subgroups were identified (entropy = 0.964), ranging from low-burden to persistently severe patterns. Subgroup membership was partially associated with age, tumor grade, and diagnosis. These subgroups were: transient postoperative burden group, stable symptom with cognitive emergence group, distress-predominant, low burden group, elderly-high grade, persistently severe group, nausea-dominant recovery group, and distress-plus-nausea, younger urban group.

Conclusion: Our findings reveal substantial heterogeneity in perioperative symptom experiences among brain tumor patients. Identifying subgroups with high and persistent symptom burden may help clinicians target interventions such as enhanced education, proactive monitoring, rehabilitation, psychological support, and antiemetic management. This subgroup-based approach may improve quality of life, reduce morbidity, and guide precision supportive care in neuro-oncology.

Objective: This study aimed to describe the changes in the etiology of adult epilepsy in different age groups over the past 25 years, with consideration of different time periods.

Methods: A retrospective study was conducted using the clinical data of patients with adult-onset epilepsy at The First Medical Center of Chinese PLA General Hospital between February 1999 and March 2024.

Results: The study included 5,712 patients from 25 provinces and 4 municipalities in China. The study found that the prevalence of unknown etiology has decreased overall, particularly after 2015, and that the proportion of epilepsy cases caused by metabolic etiologies has declined since 2016. However, since 2021, there has been an increase in immune-related epilepsy. The proportion of patients with structural epilepsy ranged from 29.7% to 90% across all age groups. Among epilepsy patients aged ≥ 51 years, structural epilepsy was predominant, accounting for the majority of cases. In particular, the proportion of epilepsy attributable to cerebrovascular disease increased with age at onset. With regard to gender, structural epilepsy was more common in males than in females.

Conclusions: This study highlights observed trends and changes in clinical diagnosis in epilepsy etiologies, revealing an obvious decrease in unknown etiology. The recent rise in immune-related epilepsy underscores the need for increased clinical vigilance. The observed gender and age disparities in structural epilepsy, particularly cerebrovascular-related cases in elderly males, provide critical insights for targeted preventive and therapeutic strategies.

Background: Age is defined as the patient's chronological age (in years) at hospital admission. The association between age and angiographic vasospasm remains controversial. This study aimed to explore the association between age and angiographic vasospasm in mechanically ventilated patients with aneurysmal subarachnoid hemorrhage (aSAH).

Methods: A secondary analysis was performed based on a retrospective study conducted from 2010 to 2015 in the intensive care unit (ICU) of a French university hospital. Factors associated with angiographic vasospasm were identified using univariate and multivariate logistic regression analyses. The non-linear relationship between age and angiographic vasospasm was assessed using restricted cubic spline regression, and the threshold effect was evaluated using a two-piecewise linear regression model.

Results: The study included 231 mechanically ventilated patients with aSAH. Their median age was 56 years (range, 19-84 years). Patients were divided into two groups based on the median age of 56 years: younger (< 56 years) and older (≥ 56 years). The rate of angiographic vasospasm was 34.63% (N = 80). After adjusting for potential confounders, patients in the older group were less likely to develop angiographic vasospasm [odds ratio (OR), 0.40; 95% confidence interval (CI), 0.19-0.85; p = 0.017] compared with those in the younger group. After adjusting for confounders, when age was ≤ 53 years, the risk of angiographic vasospasm increased by 13% for each year increase in age (OR, 1.13; 95% CI, 1.05-1.22; p = 0.002). For age > 53 years, the risk of angiographic vasospasm decreased by 17% for each year increase in age (OR, 0.83; 95% CI, 0.77-0.89; p < 0.001).

Conclusion: Age was non-linearly associated with the risk of angiographic vasospasm in mechanically ventilated patients with aSAH.